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Page: << Prev | 1 | 2 But, Simon Finfer, of the George Institute for International Health, and Anthony Delaney, of the Royal North Shore Hospital in Sydney, Australia, wrote in an accompanying editorial that it's possible that some of the studies included in the meta-analysis were flawed or that the meta-analysis itself was flawed.
"Possible explanations for the discordant results of the study by van den Berghe et al and the meta-analysis by Wiener et al are that the meta-analysis is flawed, the studies that form the basis of the meta-analysis are flawed or
inherently different, or the findings of the study by van den Berghe et al
occurred due to random chance or as a result of another unique factor
interacting with tight glycemic control."
They added that "those investigating tight glycemic control should take a step back and address the fundamental questions of defining quality standards for tight glycemic control, finding affordable methods of frequent and highly accurate measurement of blood glucose in the ICU, and conduct multicenter efficacy studies to determine if tighter glycemic control can reduce mortality under optimal conditions. If tighter glycemic control can be proven effective in optimal conditions, determining how to make that benefit available to millions of critically ill patients in both developed and resource-poor countries around the world would be a truly worthwhile challenge. There is no simple or clear answer to the complex problem of glycemic control in critically ill adults; at present, targeting tight glycemic control cannot be said to be either right or wrong."
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More information
The American Thoracic Society has more about critical care.
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-- Robert Preidt
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